CIGNA can not change ERISA standard of review

United States 2nd Circuit Court of Appeals decided March 2006

In Gibbs v. Cigna, the parties disputed whether the summary plan description reserved discretionary authority to the plan administrator. If so, the administrator’s decision would be reviewed on appeal under an arbitrary and capricious standard. If not, the plaintiff would be entitled to de novo review.

At issue in this case were two competing summary plan descriptions.

CIGNA argued that the language of the 1997 summary plan description vested sole discretion in the administrator. By contrast, the plaintiff argued that the 1995 summary plan description, which did not grant such discretion, controlled because that was the language in effect when the he became disabled.

The Second Circuit agreed with the plaintiff finding that “Gibbs was vested in his right to disability benefits prior to the amendment of the plan.” The Court went on to hold that a change in the discretion allocated to an administrator substantively affects a claimant’s rights to benefits. Accordingly, the Court found that such a change cannot be applied retroactively to a disability claim that has already vested. The district court opinion to the contrary was vacated and the case was remanded for further proceedings.

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Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Cigna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Cigna.

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Our lawyers help individuals that have either purchased a Cigna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Cigna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

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When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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